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Authors Institution
Ana L. Da Silva
Michelle Mclean
Judy Mckimm
Stella Major
Swansea University, College of Medicine, Swansea, UK
Bond University, Faculty of Health Sciences and Medicine, Queensland, Australia
United Arab Emirates University, College of Medicine and Health Sciences, Abu Dhabi, UEA
Theme
International Dimensions
'Medical educators on the move': experiences of international medical educators
Background

 In an article in the internationalisation of medical education, Harden (2006), envisaged the medical education of the future to be “transnational”. With globalisation and the blurring of national boundaries, Harden saw medical education of the future being a scenario where the students, teachers and the curriculum are all “international”. Several models of medical education are currently in practice: universities recruiting international students, universities recruiting international faculty, either to teach local students  or, with the offshoring of many medical schools (e.g. Cornell Qatar), local and international faculty to teach local and international students.

While much has been written about the experiences of international students (usually in a foreign country), little has been documented about the international teacher. The reasons for “international” teachers joining a faculty outside their home country are numerous. For some, this might be their first experience in such a situation, while for others, it may be the second or third position as an international teacher. The aim of this study is to gather information about the experiences of international medical teachers/educators (i.e. working outside their home country) with a view to understanding their reasons for working abroad and the impact of this decision on their personal and professional lives.

Summary of Work

The current research is situated upon the pragmatic approach or paradigm making use of a mix-methods methodology where quantitative analysis and qualitative analysis are combined as serving complementary purposes within the current research.

Data was collected by an online survey on experiences distributed via medical education malling lists, twitter (#meded) and the researchers contacts. Data were analysed using TAMS Analyzer (qualitative) and SPSS19.0 (quantitative).

We collected data from 89 respondents, with an average age of 51 years old ranging between a minimum of 28 and a maximum of 82 years old.  A total of 58% were male respondents and 40% were female.

Figure 1-Geographical distribution respondents answers to the question" Which Country do you consider as 'home'?

 

‘Home’ country:

From a total of 29 different countries (birth country) spread over the 7 different continents, the majority of participants are European (58%), followed by Asian (17%) and North America (13%). With the five top countries being UK (England, Wales, Scotland and North Ireland) (31), US (8), Netherlands (7), Pakistan (7) and Canada (4). 

The majority of the participants describes themselves as "westerners" (55%) or "global citizens" (12%), with 30% reporting UK as their home country, followed Australia, Pakistan, US, Ireland, Netherlands, New Zealand, Canada, and Germany (full country distribution is shown in figure 1). However 15% of participants said “it is difficult ” or chosen more than one country as a home country as "home" country. 

Also worth notice in these comments is the use of the word “now” to characterize home country as the country where they are living and/or feel better in, transcending the conventional idea of “home country” as a country of birth. 

International Experience:
The respondents reported working on average 4.3 in countries, ranging form a minimum of 2 and a maximum of “40 plus” and having a (mean of) 9.3 years of international experience.

 

Language:

English is the most common home language, with 63% of the respondents reporting it as their home language, 24% of our sample reported speaking only their home language, 37% reported speaking one other language apart from their home one, 21% speaking two and 16% three or more languages a part from their home. 

Conclusion

 

The scenario our results show is slightly different from that suggested by Harden in 2006. International medical educators are being employed for their expertise to teach local curricula.  Although globalisation has led to the blurring of national boundaries and medical educators are “on the move”, the students and the curricula remain largely local.

Becoming an international medical educator seems to involve a set of personal and professional attributes allied to opportunities for international work and the ability to thrive under often challenging, ‘uncomfortable’ situations and change their worldview as a consequence of these experiences. Familiarisation with local culture, language, and region prior to arrival is recommended. Support from hosting institutions to new international teachers is seen as important.

Take-home Messages
  • Internationalisation of medical educators and teachers is a reality;
  • The experiences this international workforce brings are of great value to institutions and students;
  • More needs to be understood about how institutions can support, assimilate and integrate this workforce;
  • Familiarisation with local culture, language, and region prior to arrival is recommended;
  • Support from hosting institutions to new international teachers is seen as important.


Acknowledgement

The authors of this study would like to thank all participants and colleagues who helped with the survey distribution.  

Summary of Results

Becoming and Being an International Medical Educator:

According to our respondents becoming an international medical educator is a process resulting from the combination of positive attitudes towards other cultures (wider world view); personal attributes and values (openness to new experience); opportunities for and experiences of working internationally; the ability to thrive with the challenges presented by these experiences and learn from these experiences (Figure 2 and video).

International medical educators described a wide vary of responsibilities and experiences (Figure 3) ranging from academic appointments to participation in Aid/Development programmes. However, whilst some respondents had only one main role (typically, academic posts) in several countries, others have been involved in a multiplicity of roles throughout their international career. From all the posts described, 70% involved teaching local students and 30% international students

Figure 2 - Becoming an International Medical Educator

 

 

 

Figure 3 - Being an International Medical Educator 

 

 

 


'Pros' and 'Cons' for institutions:

 

International medical educators bring different perspectives, innovation and expertise and help facilitate international collaborations, connections and networking. However there is also a ‘dark side’ to working internationally in terms of potential “educational colonialism”, a lack of knowledge of local cultures, longer adaptation periods and communication barriers. However if adequate support is in place and educators have cultural sesitivity, these barriers can be overcome

Table 1 - Benefitis and challenges for institutions of international medical educators.

 

“Pros” for institutions

“Cons” for institutions

Different (world) perspectives/broader view of the world

Need to provide support for adaption to new context

Innovation/change/questioning

Inadequate acculturation /Slower acculturation/integration

Expertise

Lack of long term commitment

Links with other institutions/network

Communication/language barriers/support

Promoting international perspective on health

Educational colonialism

Learn form others practices

Lack of knowledge of local needs/paternalism /Cultural Imperialism

 

References

1.     Enders, J. & Teichler, U., 2005. Academics’ View of Teaching Staff Mobility. The Professoriate, pp.97–112. Available at: http://www.springerlink.com/index/x526g341q0204565.pdf [Accessed June 11, 2012].

2.     Harden, R.M., 2006. International medical education and future directions: a global perspective. Academic medicine: journal of the Association of American Medical Colleges, 81(12 Suppl), pp.S22–9. Available at:http://www.ncbi.nlm.nih.gov/pubmed/17086041.

3.     Hofstede, GJ, Pedersen, PB, Hofstede, G. 2002. Exploring Culture: Exercises, Stories and Synthetic Cultures. Intercultural Press, Yarmouth, ME.

4.     Koehn PH, Swick M. 2008. Medical education for a changing world: moving beyond cultural competence into transnational competence. Academic Medicine 84: 548-556.

5.     McKimm J, McLean M. 2011. Developing a global health practitioner: Time to act? Medical Teacher 33: 626–631. 

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Background
Summary of Work
Conclusion
Take-home Messages
Acknowledgement
Summary of Results
References
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